Lateral Rhinotomy: Overview

Lateral rhinotomy surgery is designed to give healthcare providers a better look inside the nose to surgically remove tumors or other masses within the nasal cavity. During the surgery, the majority of the nasal cavity is exposed. The anterior skull base, which is the wall at the top of the sinuses, can also be partially exposed during lateral rhinotomy.

This article discusses the surgical process, potential risks, and what to expect when undergoing this surgery.

What Is a Lateral Rhinotomy?

Lateral rhinotomy is a type of surgical procedure that helps healthcare professionals get a deeper, more effective exposure to many areas of the sinus cavity. It is performed by making an incision in one side of the outer nose and pulling the skin off the nose.

Various Surgery Techniques

While a lateral rhinotomy is typically done using one type of incision, there are a few different variations that can be used. These include:

• Subciliary incision: A subsciliary incision takes place underneath the lower eyelashes.
• Lip-splitting incision: A lip-splitting incision utilizes an incision through the upper lip to better look within the facial cavity. This variation is called a Weber-Ferguson incision.
• Combination incision: This process involves a combination of either a typical lateral rhinotomy incision and one or both of the alternatives.

Contraindications

Typically, lateral rhinotomy surgeries can be conducted on anyone of any age. The surgery itself is not extremely complicated and does not pose risk in relation to a person’s age. That said, there are some complications that can occur following the surgery.

Potential Risks

As is the case with any surgery, some potential risks can occur following a lateral rhinotomy. These risks include:

• Facial scarring where the incision took place
• Excessive crusting of the nasal passages
• Facial paresthesia, which is a tingling or burning feeling in the face
• Excessive and uncontrollable tearing of the eyes
• A loss of feeling in the face
• Changes, reductions, or distortions in one’s ability to smell
• Change in the shape or appearance of the nose
• Hemorrhage

Purpose of a Lateral Rhinotomy

The main purpose of a lateral rhinotomy is access to remove tumors of the sinuses and anterior skull base.

For example, if a person is experiencing difficulties breathing through their nose, they may have a tumor within their nasal cavity that is blocking the airway. The lateral rhinotomy surgery can help gain access to the tumor to remove it properly.

More specifically, symptoms that may prompt a healthcare provider to suspect a tumor and use lateral rhinotomy surgery to remove it include:

• Watering eyes
• Nasal obstruction
• Chronic nosebleeds
• Swelling in the upper jaw with no known cause
• Bulging eyes
• Double vision
  

Conditions that are typically diagnosed or treated using the procedure include:

• Tumors (both cancerous and non-cancerous)
• Various types of fibromas, which are masses of connective tissue
• Adenocarcinoma
• Fibrous dysplasia, which occurs when tissue that resembles scar tissue forms instead of bone

How to Prepare

While it’s unlikely you will have to do much to prepare for the procedure, there are some things that you can do that can make the process easier.

For example, you may be prescribed antibiotics to take for up to a week prior to surgery so that the risk of developing an infection after surgery is reduced.

In some cases, especially if cancer is suspected, you will have to see other medical specialists before your surgery to help lower the risk of any complications involving breathing or your ability to smell.

What to Expect on the Day of Surgery

Your healthcare provider or surgeon will take the following measures to make sure the procedure goes as smoothly as possible:

1. You will be put under a general anesthetic so that you do not feel pain from the procedure.
2. A tube will be placed into your mouth and down into your trachea to keep you ventilated during the surgery.
3. Your eyelids may be partially sewn together so that they remain closed during the entire operation. This will occur after you have already been put under anesthesia.
4. Your healthcare provider will give you specific instructions about what to eat and drink on the day of surgery. It’s important to follow the guidelines exactly, as they are meant to help lower the risk of potential complications.

You’ll want to make sure that you’re dressed comfortably and have someone that can drive you home once you are out of surgery.

Recovery

Recovery from lateral rhinotomy involves healing and monitoring. The incision will heal in its own time, because the rate of wound healing highly depends on how quickly a person's body heals itself.

Depending on the cause and whether or not any mass has been removed, recovery will differ for each person who has undergone lateral rhinotomy surgery.

Long-Term Care

Long-term care involves monitoring yourself for any symptoms that may recur. Although it doesn’t happen in all cases, some conditions that require the use of lateral rhinotomy can recur.

In the event that your symptoms do return, and a new mass forms within your nasal cavity, you may have to undergo the procedure again or speak to your healthcare provider about other options.

Follow-ups with your healthcare provider will be important. They are done at two weeks, one month, two months, six months, and one year following surgery.

Summary

Lateral rhinotomy surgery is a procedure that uses an incision to cut the skin on the side of the nose so it can open fully. It is performed to gain surgical access to the inside of the nasal cavity for masses or other nasal issues. The surgery is warranted when someone experiences symptoms associated with various conditions that cause masses to form in the sinuses.

The surgery itself is done under general anesthesia and recovery time will vary on a case-by-case basis. If you have the surgery, you will likely have to monitor yourself for any changes, symptoms, or complications. You will also have to attend follow-up appointments with your healthcare provider regularly throughout the first year post-operation.

A Word From Verywell

Surgery can be a frightening experience, especially when that surgery takes place on your face. While getting a lateral rhinotomy is fear-inducing, not getting it could be much worse, because you don’t want to leave the possibility of something like cancer left untreated. Talk to your healthcare provider about the advantages of having a lateral rhinotomy for prolonged or concerning symptoms.